Does the Use of Immunosuppressive Drugs Impact on SARS-CoV-2 Infection Outcome? Data From A National Cohort of Patients With Immune-Mediated Inflammatory Diseases (SAR-COVID Registry).

BACKGROUND/OBJECTIVE: This study describes the impact of immunomodulatory and/or immunosuppressive (IM/IS) drugs in the outcomes of COVID-19 infection in a cohort of patients with immune-mediated inflammatory diseases (IMIDs). METHODS: Adult patients with IMIDs with a confirmed SARS-CoV-2 infection were included. Data were reported by the treating physician between August 13, 2020 and July 31, 2021. Sociodemographic data, comorbidities, and DMARDs, as well as clinical characteristics, complications, and treatment of the SARS-CoV-2 infection, were recorded. Descriptive analysis and multivariable logistic regression models were carried out. RESULTS: A total of 1672 patients with IMIDs were included, of whom 1402 were treated with IM/IS drugs. The most frequent diseases were rheumatoid arthritis (47.7%) and systemic lupus erythematosus (18.4%). COVID-19 symptoms were present in 95.2% of the patients. A total of 461 (27.6%) patients were hospitalized, 8.2% were admitted to the intensive care unit, and 4.4% died due to COVID-19.Patients without IM/IS treatment used glucocorticoids less frequently but at higher doses, had higher levels of disease activity, were significantly older, were more frequently hospitalized, admitted to the intensive care unit, and died due to COVID-19. After adjusting for these factors, treatment with IM/IS drugs was not associated with a worse COVID-19 outcome (World Health Organization-Ordinal Scale ≥5) (odds ratio, 1.24; 95% confidence interval, 0.73-2.06). CONCLUSIONS: SAR-COVID is the first multicenter Argentine registry collecting data from patients with rheumatic diseases and SARS-CoV-2 infection. After adjusting for relevant covariates, treatment with IM/IS drugs was not associated with severe COVID-19 in patients with IMIDs. STUDY REGISTRATION: This study has been registered in ClinicalTrials.gov under the number NCT04568421.

Sociodemographic and clinical factors associated with poor COVID-19 outcomes in patients with rheumatic diseases: data from the SAR-COVID Registry.

BACKGROUND/OBJECTIVE: This study aims to describe the course and to identify poor prognostic factors of SARS-CoV-2 infection in patients with rheumatic diseases. METHODS: Patients ≥ 18 years of age, with a rheumatic disease, who had confirmed SARS-CoV-2 infection were consecutively included by major rheumatology centers from Argentina, in the national, observational SAR-COVID registry between August 13, 2020 and July 31, 2021. Hospitalization, oxygen requirement, and death were considered poor COVID-19 outcomes. RESULTS: A total of 1915 patients were included. The most frequent rheumatic diseases were rheumatoid arthritis (42%) and systemic lupus erythematosus (16%). Comorbidities were reported in half of them (48%). Symptoms were reported by 95% of the patients, 28% were hospitalized, 8% were admitted to the intensive care unit (ICU), and 4% died due to COVID-19. During hospitalization, 9% required non-invasive mechanical ventilation (NIMV) or high flow oxygen devices and 17% invasive mechanical ventilation (IMV). In multivariate analysis models, using poor COVID-19 outcomes as dependent variables, older age, male gender, higher disease activity, treatment with glucocorticoids or rituximab, and the presence of at least one comorbidity and a greater number of them were associated with worse prognosis. In addition, patients with public health insurance and Mestizos were more likely to require hospitalization. CONCLUSIONS: In addition to the known poor prognostic factors, in this cohort of patients with rheumatic diseases, high disease activity, and treatment with glucocorticoids and rituximab were associated with worse COVID-19 outcomes. Furthermore, patients with public health insurance and Mestizos were 44% and 39% more likely to be hospitalized, respectively. STUDY REGISTRATION: This study has been registered in ClinicalTrials.gov under the number NCT04568421. Key Points • High disease activity, and treatment with glucocorticoids and rituximab were associated with poor COVID-19 outcome in patients with rheumatic diseases. • Some socioeconomic factors related to social inequality, including non-Caucasian ethnicity and public health insurance, were associated with hospitalization due to COVID-19.

Climate-driven changes of riparian plant functional types in permanent headwater streams. Implications for stream food webs.

Little is known regarding consequences of climate change on riparian plant functional types (PFTs) related to leaf traits, with putative domino effects on stream food webs, plausible even if the tipping point of stream-desiccation is not reached. We hypothesized that, as stream food-webs are highly dependent on riparian subsidies, climate change might alter PFTs to the point of weakening terrestrial-aquatic linkages. We conducted a gradient analysis to assess the relative effects of climate, soil and riparian physical characteristics on PFTs. If PFTs differ significantly in leaf traits and climate had major influences on them, we could assume space-for-time interchangeability forward in time to predict leaf traits changes, and consequences for stream food webs under future climate change scenarios. Results indicated a clear distinction in leaf traits among PFTs: woody deciduous plants showed leaf traits associated to high decomposability and nutritional value for invertebrate shredders compared to evergreen woody and giant graminoid groups. We found a prime role of climate predicting changes in abundance and diversity of PFTs: 1) a warming and precipitation-decline scenario, coupled with soil characteristics related to aridification, would have detrimental effects on deciduous plants, while fostering giant graminoids; 2) in a scenario of no precipitation-reduction in wetter areas, warming might promote the expansion of evergreen to the detriment of deciduous plants. In both scenarios the net outcome implies increasing recalcitrance of leaf litter inputs, potentially weakening terrestrial-aquatic linkages in headwater streams.

Kikuchi-Fujimoto disease and systemic lupus erythematosus.

Kikuchi-Fujimoto disease, or histiocytic necrotizing lymphadenitis, is an infrequent idiopathic disorder. It has been associated with autoimmune disorders, of which systemic lupus erythematosus is the most outstanding. The basis of its diagnosis relies on the histological examination of lymph nodes, which typically reveals necrosis surrounded by histiocytes with crescentic nucleus, immunoblasts and plasma cells, and absence of neutrophils. We report the case of a 27-year-old Argentinian female patient without any relevant past medical history to demonstrate the correlation between Kikuchi-Fujimoto disease and systemic lupus erythematosus.

Phylogeny of the tribe Fumarieae (Papaveraceae s.l.) based on chloroplast and nuclear DNA sequences: evolutionary and biogeographic implications.

PREMISE OF THE STUDY: Little research has been done at the molecular level on the tribe Fumarieae (Papaveraceae). Papaveraceae is a model plant group for studying evolutionary patterns despite the lack of a reference phylogeny for this tribe. We investigated the phylogenetic relationships within the tribe to complete the molecular data for this family in order to help understand its character evolution and biogeographic pattern. METHODS: We used maximum-parsimony and Bayesian approaches to analyze five DNA regions for 25 species representing 10 of the 11 Fumarieae genera and five outgroups. Evolutionary pathways of four characters (habit, life span, type of fruit, and number of seeds per fruit) were inferred on the phylogeny using parsimony. The ancestral distribution areas were reconstructed using dispersal-vicariance analysis. KEY RESULTS: Fumarieae is monophyletic and includes three groups that agree with the morphology-based subtribes: Discocapninae, Fumariinae, and Sarcocapninae. Within subtribes, the relationships among genera were different from those obtained with morphological data. Annual life span, nonchasmophytic habit, and a several-seeded capsule were the basal character states for the tribe. The ancestor occupied a continuous area between West Eurasia and Africa. Vicariances explain the divergence between lineages Discocapninae (South Africa) and Fumariinae-Sarcocapninae (Mediterranean), and the disjunction of Fumariinae (Mediterranean-Central Asia). CONCLUSIONS: Molecular phylogeny confirms the subtribal classification of Fumarieae based on morphology. However it provides different results regarding the relationships among genera within each subtribe, which affects the inference of the evolutionary pathway followed by the four selected characters. The disjunct distribution of the tribe is explained by different vicariance scenarios.

Use of environmental scanning electron microscopy to image poly(N-isopropylacrylamide) microgel particles.

Poly(N-isopropylacrylamide) microgel samples previously characterized with several techniques [M.J. García-Salinas, M.S. Romero-Cano, F.J. de las Nieves, J. Colloid Interface Sci. 241 (2001) 280-285] are directly observed in this work using an Environmental Scanning Electron Microscope (ESEM). This is a novel approach to microgel studies, because the particles are close to their "natural" or hydrated state. In the ESEM sample chamber, the relative humidity can be chosen by controlling independently water vapour pressure and sample temperature. Microgel particle size is affected by changes in these variables. The changes in diameter are followed for a set of individual, specific particles, detecting for each of them a size increase with relative humidity. This shows the possibility of following a dynamic process (i.e. hydration) in situ, for a specific particle. Several sets of images in different conditions are obtained for two microgels with different amount of cross-linker and co-monomer. The swelling behaviours are compared. A linear relation is found between particle diameter measured from ESEM images and relative humidity, the slope being positive and higher for particles with a lower level of cross-linker. It is shown that extrapolating data from ESEM measurements is a good method to estimate collapsed diameters. The collapsed particle diameters measured from Transmission Electron Microscopy (TEM) and ESEM are in good agreement. Thus, ESEM technique provides size data similar or complementary to previous measurements obtained by other techniques, i.e. photo-correlation spectroscopy (PCS) and TEM. In this way, the whole range of microgel sizes, from the biggest (swollen) diameter to the collapsed one, that is, the complete shrinking behaviour is studied combining different devices.

Reticulate evolution in the Acrolophus subgroup (Centaurea L., Compositae) from the western Mediterranean: origin and diversification of section Willkommia Blanca.

Section Willkommia (Centaurea, Compositae) is endemic to the east-central portion of the Iberian Peninsula and northwestern Africa. The section has been included with sections Acrolophus and Phalolepis in the informal subgroup Acrolophus. We have used a molecular phylogenetic approach to test the hypothesis proposed by earlier authors that the diversification of section Willkommia involved a schizoendemic process from an ancestral syngameon. Comparative analysis of the transcribed spacer sequences of the nuclear ribosomal DNA (ITS and 3'ETS) regions reveals the presence of three different types of ribosomal sequences in the Acrolophus subgroup (referred to here as the Willkommia, Acrolophus-Phalolepis and Simulans ribotypes) which show a sectional-independent geographic structure. This evidence, together with the presence of additive polymorphic sites in the Willkommia sequences which agree with the geographic distribution of the taxa, suggests that members of section Willkommia and the western Mediterranean taxa of sections Acrolophus and Phalolepis fit a reticulate evolution model.